This week on The Tox Lab, we’re discussing brorphine — a novel synthetic opioid that briefly appeared on the drug market around 2020.
We explore its emergence and pharmacology, including data on its activity at the µ-opioid receptor. We also discuss one of the few documented case studies describing an individual presenting for detoxification following brorphine use. Finally, we review recent research examining its in vitro and in vivo metabolites, highlighting how these findings may offer new ways to detect this short-lived substance.
Although brorphine is now under international control, could other “orphine” analogues step into the spotlight, potentially replacing nitazenes as the next wave of synthetic opioids?
Join us as we unpack the chemistry, the risks, and what the story of brorphine reveals about the constantly shifting landscape of synthetic opioids.
Hope you enjoy!
Links to the papers we discussed:
https://academic.oup.com/jat/article-abstract/44/9/937/5879253?login=false
https://www.sciencedirect.com/science/article/abs/pii/S0379073821003091?via%3Dihub
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re celebrating our 50th episode — and one whole year of toxicology talk! 🎉
Join us as we look back on some of our most memorable moments from the past year, revisit a few topics with new updates, and share what’s next for The Tox Lab.
Whether you’ve been here since episode one or you’re just joining us, thank you for being part of our growing community of toxicologists, scientists, and curious listeners. Here’s to another year of exploring the science behind the substances!
Hope you enjoy!
Link to ketamine paper we mentioned:
https://journals.sagepub.com/doi/10.1177/02698811251373058
Disclaimer: All opinions are our own.
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Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re revisiting one of history’s most infamous poisons — arsenic.
Once dubbed the king of poisons, arsenic still poses real risks today. We discuss recent research on arsenic in the water supply and how prenatal exposure may influence birth outcomes in the United States. We also review two unusual cases of intentional elemental arsenic ingestion, exploring the unexpected clinical effects observed, along with a case of chronic arsenic toxicity.
Join us as we uncover how this Victorian-era poison continues to challenge toxicologists in the modern world.
Hope you enjoy!
Links to the papers we discussed:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2835321
https://www.tandfonline.com/doi/full/10.1080/15563650.2025.2496223
https://link.springer.com/article/10.1007/s12328-024-02045-3
Disclaimer: All opinions are our own.
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Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re embracing autumn and diving into the fascinating, and sometimes dangerous, world of mushrooms.
We explore ten years of mushroom exposure data reported to the UK National Poisons Information Service, examining the species most often involved and the mechanisms behind their toxicity. We also take a look at commercial products containing mushrooms and discuss a paper showing that some may not always contain what they claim.
Join us as we unpack the science, the surprises, and the toxicology of mushrooms this autumn.
Hope you enjoy!
Links to papers we discussed:
https://www.tandfonline.com/doi/full/10.1080/15563650.2025.2507357
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2838765
https://www.health.nsw.gov.au/sabs/Documents/2024-sn-015.pdf
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re taking a closer look at clozapine, a highly effective antipsychotic with a complex toxicological profile.
We review a study from Western Sydney examining cases of self-poisoning and adverse drug reactions, discuss a case of chronic clozapine toxicity, and explore new research into its effects on cardiac mitochondria.
From clinical outcomes to cellular mechanisms, we unpack the risks, challenges, and unanswered questions around this fascinating but unpredictable drug.
Hope you enjoy!
Links to the papers we discussed:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10522536/
https://pmc.ncbi.nlm.nih.gov/articles/PMC11954577/
https://www.sciencedirect.com/science/article/pii/S2214750025001088?via%3Dihub
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re discussing medetomidine and its unexpected association with hallucinations.
We review a recent paper highlighting its emergence in the drug supply and the apparent increase in hallucinatory effects reported with its use. Although medetomidine has been linked to reducing post-operative delirium, we also discuss a case report of dexmedetomidine-induced delirium in a patient with schizophrenia — adding to the complexity of this picture. And yes, we even wonder what dogs might be dreaming about when they come round from their vet visit.
We then explore a possible mechanism for these effects, including the hypothesis that activity at the kappa opioid receptor could play a role.
We'd love to hear your thoughts on this, so please get in touch!
Hope you enjoy!
Links to the papers we discussed:
https://onlinelibrary.wiley.com/doi/10.1111/dar.70024
https://pmc.ncbi.nlm.nih.gov/articles/PMC11312422/
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re taking a closer look at diphenidine and other diarylethylamines — a class of drugs that briefly emerged as alternatives to ketamine.
We explore their history, reported effects, and the fatalities linked to their use before they faded from the drug scene.
With current discussions around reclassifying ketamine, we ask: could diphenidine — or similar substances — make a comeback?
Join us as we unpack the toxicology, the risks, and the lessons from their short but impactful appearance.
Hope you enjoy!
Link to the paper we discussed:
https://journals.sagepub.com/doi/10.1177/02698811251349203?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re diving into the world of GLP-1 receptor agonists, including the well-known weight loss drug Ozempic.
We explore how these drugs work and their potential benefits beyond weight loss, including effects on heart health. We then discuss a case of intentional Ozempic overdose, examining the clinical presentation and outcomes.
Finally, we turn to the growing problem of counterfeit Ozempic — exploring what’s really in these fake products, why people are taking the risk, and the dangers this trend poses for public health.
Join us as we unpack both the promise and the pitfalls of this so-called “miracle” drug.
Hope you enjoy!
Links to the papers we discussed:
https://journals.lww.com/practicalpsychiatry/abstract/2024/11000/clinical_manifestations_of_semaglutide_overdose__a.10.aspx
https://jamanetwork.com/journals/jama/article-abstract/2821502
https://www.bmj.com/content/383/bmj.p2506.full
https://pmc.ncbi.nlm.nih.gov/articles/PMC10739421/
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re shaking things up with a case-based mystery episode.
We walk through four real-life poisoning cases, starting with how each patient presented and progressed, before revealing the substance behind the toxic effects.
Can you solve the puzzle before we uncover the cause?
If you like this style of episode, let us know in the comments below!
Hope you enjoy!
⚠️ Spoiler alert!
Links to the papers we discussed:
A case of glitter poisoning: https://www.thepoisonjournal.com/articles/severe-glitter-poisoning-case-report
Snake firework ingestion: https://www.tandfonline.com/doi/full/10.1080/15563650.2025.2474563
Mass Aconite poisoning:https://www.tandfonline.com/doi/full/10.1080/15563650.2025.2526115 - Don't forget to check out The Poison Lab podcast for a deep dive into this case!
A case of bromism ingestion after AI advice: https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260
Editor’s note: Yes, we mixed up “chloride” with “chlorine” and “bromide” with “bromine.” If you do the same, don’t worry — we’ll cover your case in a future episode.
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re talking about 2C-B and “Tusi” — two drugs often confused, but very different in composition and effects.
We explore Dutch Poison Information Centre data on 2C-B, examining reported exposures and the spectrum of effects across low, moderate, and high doses. We then turn to casework from the Miami-Dade Medical Examiner Toxicology Laboratory to look at “Tusi” (also known as Tucibi or pink cocaine), discussing what’s actually found in these samples and what this means for interpretation.
Join us as we untangle the realities behind these two commonly misunderstood substances.
Hope you enjoy!
Links to the papers we discussed:
https://www.sciencedirect.com/science/article/abs/pii/S019606442030278X#:~:text=Conclusion,addition%20to%20mild%20somatic%20effects
https://onlinelibrary.wiley.com/doi/epdf/10.1111/1556-4029.70012
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re taking a closer look at ibogaine — a plant-derived alkaloid attracting interest as a potential treatment for addiction.
We discuss a study from New Zealand exploring its use in opioid dependence, while also highlighting the serious risks reported in case studies, including severe cardiotoxicity. We then turn to National Poisons Information Service data to examine recent trends in ibogaine use in the UK.
Can the therapeutic potential of ibogaine ever outweigh its dangers? Join us as we unpack the evidence, the risks, and the unanswered questions around this compound.
Hope you enjoy!
Link to the papers we discussed:
https://www.tandfonline.com/doi/10.1080/00952990.2017.1310218?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
https://www.tandfonline.com/doi/full/10.1080/15563650.2024.2447500#:~:text=Our%20cases%20are%20consistent%20with,of%20cardiac%20output%20and%20arrest
https://onlinelibrary.wiley.com/doi/full/10.1002/joa3.12061
https://erowid.org/experiences/exp.php?ID=63089
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re diving into the surprising sides of nicotine.
Beyond its well-known risks, we explore how nicotine might have therapeutic potential in conditions like schizophrenia and dementia—where deficits in nicotinic acetylcholine receptors could play a role. We also discuss the MIND study, which is testing whether nicotine can boost memory, attention, and learning in dementia patients.
Then, we turn to the other side of the story—nicotine as a poison—examining U.S. poison centre data on exposures in children, and what trends and outcomes tell us about the risks.
From possible medicine to dangerous toxin, join us as we explore the full spectrum of nicotine’s impact.
Hope you enjoy!
Links to papers we discussed:
https://pmc.ncbi.nlm.nih.gov/articles/PMC9020415/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10854606/
https://clinicaltrials.gov/study/NCT02720445
https://publications.aap.org/pediatrics/article/156/2/e2024070522/202640/Nicotine-Ingestions-Among-Young-Children-2010-2023?autologincheck=redirected
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re taking a closer look at BTMPS.
A compound used as a light stabiliser in plastics, BTMPS unexpectedly surfaced in the U.S. drug supply in the summer of 2024.
We unpack what’s known so far about its emergence, discuss possible reasons for its appearance, and revisit earlier research exploring its activity at nicotinic acetylcholine receptors and signs of cardiotoxicity in animal models.
Join us as we examine what makes this compound so unexpected—and why it’s raising eyebrows in toxicology.
Hope you enjoy!
Links to the papers we discussed:
https://jamanetwork.com/journals/jama/fullarticle/2829939
https://www.sciencedirect.com/science/article/abs/pii/S0376871625002169?via%3Dihub
https://www.cfsre.org/nps-discovery/public-alerts/an-update-on-the-presence-of-btmps-in-the-drug-supply-and-the-discovery-of-tetramethylfentanyl-related-substances#:~:text=in%20April%202025%20and%20since,acquisition%20of%20standard%20reference%20material
https://academic.oup.com/toxsci/article-abstract/77/2/368/1678969?redirectedFrom=fulltext
https://www.sciencedirect.com/science/article/abs/pii/S0028390809003141?casa_token=Fhh1rnqcuBcAAAAA:YpFG5go4VuiD9gW-cpdH1eipRNS6R104T68cuhwSF-wyp7piS8yp_UvpCi3wbreT_M82npMYVrE4
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re taking a closer look at death cap mushrooms following the recent conclusion of the Erin Patterson case.
We explore the toxicology of Amanita phalloides, from the mechanism of amatoxins to the clinical course of poisoning and the challenges of treatment. We also look at poison centre data from California to understand how often suspected exposures are reported—and how they present in real-world cases.
Join us as we unpack the toxicology of one of the world’s deadliest mushrooms.
Hope you enjoy!
Linked to the paper we discussed:
https://www.tandfonline.com/doi/full/10.1080/15563650.2023.2276674
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we’re diving into novel nitazene metabolites in post-mortem toxicology.
We discuss findings from our own paper identifying metabolites of protonitazene in post-mortem casework, and highlight the variability in metabolites identified and what this might mean for identifying nitazene exposure. We also examine a post-mortem case report on 5-amino and 5-acetamido metonitazene which discusses if their presence may be the result of metabolism or instability within the sample.
Join us as we unpack the complexity of interpreting nitazenes in the post-mortem setting.
Hope you enjoy!
Links to the papers we discussed:
https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf042/8128869
https://academic.oup.com/jat/article-abstract/48/9/691/7747396?login=false
https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf070/8203075?redirectedFrom=fulltext
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
In this week's episode, we’re exploring the role of AI in toxicology. From large language models supporting drug identification to machine learning tools navigating the vast datasets produced by high-resolution mass spectrometry, we look at how artificial intelligence could be integrated into toxicological workflows.
We also discuss the limitations — including bias in training data, challenges with messy or incomplete datasets, and the importance of expert oversight in clinical and forensic applications.
Join us as we unpack the promise and pitfalls of AI in the evolving world of toxicology.
Hope you enjoy!
Linked to the letter we discussed: https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf036/8123742?redirectedFrom=fulltext&login=false
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we're diving into the world of α2 adrenergic receptor agonists. We explore how xylazine, when combined with heroin, can both potentiate drug-seeking behaviour after abstinence and attenuate heroin consumption and motivation during use.
We also review a study investigating naloxone and atipamezole as potential treatments for fentanyl–xylazine toxicity and examine two forensic case studies detailing tizanidine and medetomidine concentrations to support interpretation in toxicology casework.
Join us as we unpack the clinical, toxicological, and forensic implications of this increasingly encountered drug class.
Note: In this episode, we mentioned tizanidine acting on imidazole receptors (26:58) when we meant imidazoline receptors!
Hope you enjoy!
Links to papers we discussed:
https://www.sciencedirect.com/science/article/abs/pii/S0091305725000991
https://www.tandfonline.com/doi/full/10.1080/29947448.2025.2493044
https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf056/8165439?redirectedFrom=fulltext&login=false
https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf040/8127063?redirectedFrom=fulltext&login=false
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week, we’re talking about the toxic combination of cocaine and alcohol. We explore the formation of cocaethylene, and the role both cocaine and cocaethylene play in arrhythmias and other cardiac complications. We also examine potential mechanisms of liver injury linked to cocaine use—and how alcohol may amplify this effect.
Join us as we break down the pharmacology and clinical consequences of this high-risk pairing.
Hope you enjoy!
Links to the papers we discussed:
https://academic.oup.com/jat/article-abstract/43/3/155/5363995?redirectedFrom=fulltext
https://www.mdpi.com/2077-0383/13/5/1475
https://link.springer.com/article/10.1007/s10565-024-09901-5
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
This week on The Tox Lab, we're taking a closer look at tianeptine—a drug originally developed as an antidepressant, but now making headlines as “gas station heroin” due to its opioid-like effects and increasing misuse across the U.S.
We explore a compelling clinical case of high-dose tianeptine withdrawal, examine national poison control data highlighting common symptoms and severity of presentations, and discuss a recent outbreak in New Jersey involving cases of acute toxicity linked to contaminated tianeptine products.
Tune in as we break down the pharmacology, patterns of harm, and public health concerns surrounding this emerging substance.
Hope you enjoy!
Links to the papers we discussed:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11254389/
https://link.springer.com/article/10.1007/s13181-024-01053-6
https://pmc.ncbi.nlm.nih.gov/articles/PMC11933608/
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
Why is chocolate dangerous for dogs? What makes lilies so toxic to cats? In this episode of The Tox Lab, we explore the fascinating (and sometimes surprising) toxicology of common substances that can harm our pets.
From household foods to ornamental plants, we break down the mechanisms behind these poisons, species-specific sensitivities, and what clinicians, pet owners, and toxicologists need to know when it comes to animal exposures.
Join us as we unpack the science behind pet poisoning cases and why everyday items might not be so harmless to our furry companions.
Hope you enjoy!
Disclaimer: All opinions are our own.
Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com
